Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $59.91 / $59.91	Facility	26	$59.91	$59.91	$59.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.84 / $177.36 / $588.66	Professional		$137.84	$177.36	$588.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.84 / $237.64 / $304.48	Professional		$158.84	$237.64	$304.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $569.39 / $569.39 / $950.34	Professional		$569.39	$569.39	$950.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.71 / $101.71 / $157.05	Professional	26	$101.71	$101.71	$157.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $242.30 / $256.99 / $293.70	Professional		$242.30	$256.99	$293.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.36 / $263.25	Professional		$32.34	$63.36	$263.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $936.81	Facility	26	$936.81	$936.81	$936.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.14 / $231.84 / $254.48	Professional		$229.14	$231.84	$254.48
United Facility/Professional Professional Modifier Low / Median / High Price $156.50 / $209.88 / $289.00	Professional		$156.50	$209.88	$289.00